Evidence map›Paper›PMID 40316981›Full record

SynthesisBMC medical education2025

Attitudes of undergraduate medical students towards end-of-life decisions: a systematic review of influencing factors.

Julia S Grundnig, Marlen A Roehe, Carmen Trost, Anahit Anvari-Pirsch, Anita Holzinger

Abstract readSystematic Review
In one paragraph

Synthesis in BMC medical education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Julia S GrundnigDepartment: Teaching Center, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria. Julia.grundnig@meduniwien.ac.at.ORCID http://orcid.org/0000-0002-9566-4234
Marlen A RoeheDepartment: Teaching Center, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.ORCID http://orcid.org/0000-0002-1495-5188
Carmen TrostDepartment: Teaching Center, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.ORCID http://orcid.org/0000-0001-5118-432X
Anahit Anvari-PirschDepartment: Teaching Center, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.ORCID http://orcid.org/0000-0002-3109-3487
Anita HolzingerDepartment: Teaching Center, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedical end-of-life decisions, including voluntary active euthanasia (lethal injection), (physician-)assisted dying (prescribing lethal substances), passive euthanasia (refraining from or ceasing life-sustaining treatments), palliative sedation (administering sedatives to alleviate suffering, possibly leading to unintended life-shortening), and treatment withdrawal/withholding, have become prevalent in modern medical practice.

aimThis systematic review aims to analyse international data on undergraduate medical students' attitudes towards (physician-) assisted dying, palliative sedation, treatment withdrawal/withholding, active and passive euthanasia. The objectives are to assess approval rates over the past 24 years and to identify factors influencing these attitudes.

designIn accordance with PRISMA guidelines, a systematic search of six electronic databases (MEDLINE, CINAHL, EMBASE, ERIC, PsycINFO, and Web of Science) was conducted. The review encompasses studies from 2000-2024.

resultsForty-nine studies met the inclusion criteria (43 surveys, 6 qualitative studies, 1 mixed-method study). The studies were globally distributed: Europe (27), Asia (10), America (8), Africa (3), and Australia (1). Predictors such as age, clinical vs. pre-clinical status, religious aspects, sex, and ethnicity were investigated. Age and gender had limited influence, whereas religion was a significant factor. Compared with pre-clinical students, clinical students showed more support for end-of-life practices. Geographic locations and socioeconomic status also affect attitudes.

conclusionMedical students' attitudes towards end-of-life decisions are influenced by clinical experience, religious beliefs, and geographic location. The acceptance rates for euthanasia and (physician-)assisted dying vary significantly across regions, reflecting diverse cultural and educational backgrounds.

Indexed as

Attitude of Health PersonnelStudents, MedicalTerminal CareEducation, Medical, UndergraduateEuthanasiaHumansSuicide, AssistedAssisted dyingAssisted suicideEnd-of-life decisionsEthical principlesEuthanasiaMedical studentsPalliative sedationSystematic reviewTerminal sedation

Identifiers

PMID40316981
PMCPMC12046672

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.